The Distressed College Student

How to Recognize Signs of Distress, Interact with Students, and Make Effective Referrals

The college experience is a time of self-discovery and transitions. Even changes that are exciting, that students have been looking forward to, can be a source of stress as they demand that they adapt to new situations and face new challenges. Often, along with exciting opportunities are significant losses (e.g., familiar places, friends, family, mentors, pets, religious community). Also, family life goes on and when there is stress at home, students often find themselves divided; a part of their heart at home and another at school.

Frequently, the supportive structures available at the university and the students’ own resources are enough to facilitate a successful adaptation. Sometimes, these stressors become increasingly burdensome and begin to interfere with the students’ sense of wellbeing and their ability to interact with their environment. In addition, some students arrive with a history of psychosocial challenges that further tax their resources and their ability to cope successfully. When this happens, students may become more withdrawn, their academic work suffers, their relationships deteriorate, their spiritual lives faint, and their health declines.

Faculty members are in a unique position to intervene when they identify these failures to adapt and thrive. They interact with their students often, observe how they relate to others, and through their academic work, they can identify changes in their state of mind (e.g., confused thought processes, melancholic themes, aggression, changes in quality of work). In order to accomplish this, it is important to understand the common sources and signs of distress for students and know how to interact and make effective referrals.

Student’s may have unrealistic expectations about their academic performance or might have irrational beliefs about what their family expect from them

Sometimes family members do have unrealistic expectations of students’ academic performance

Social expectations

Family expectations: Social life, personal attire, religious activities, career of choice

The sense that there are not enough hours in a day…

Conflicts: Intentions or motivations are divided between…

Roommate vs. no roommate

Own desires, beliefs, plans vs. those of boyfriend/girlfriend, marital, family

Dependence vs. self-direction

Safety vs. risk

Sexual desires vs. restraint

Study vs. play

General Signs of Distress

Changes in eating and sleeping habits

Missing classes or meetings

Falling asleep in class

Taking more naps than usual

Noticeable/Significant weight gain or loss

Anxiety about eating in public

Frequent and excessive preoccupation about food

Purging:

Compulsive, excessive, rigid, extreme exercising

Use of laxatives

Vomiting (Look for damage to teeth, bad breath)

Restricting, calorie counting

Drug and Alcohol Abuse

Student is under the influence in class

You learn that the student got in trouble because of alcohol or drug abuse (e.g., arrests, disciplinary actions)

Chronic or excessive use is a significant sign of distress given its relationship with mood disorders and anxiety.

Social Withdrawal

A sudden change in social interaction or withdrawal from social contact

Spending less time with teammates before and after practice

Not visiting friends and family as often

Spending less time talking with faculty, participating in class, talking with other students

Withdrawing from student organizations

These sudden changes in social interaction can be related to:

Feelings of shame, guilt or inadequacy

Feeling that others don’t care about them

Feeling that it’s too taxing to interact with others

Decreased interest in activities they used to enjoy

A sudden loss in interest or pleasure in doing things they once enjoyed could be a sign of depression.

Listening to music, playing an instrument, working out, dating, gaming, etc.

Losing interest in their area of studies

Giving away prized possessions is a sign of loss of interest and of potential suicidal ideation.

Neglect of appearance and hygiene

Talking about death, dying, or “going away”

Comments about their desire to die or go away or talking more about death in general are signs of depressed mood. These include expressions of hopelessness or meaninglessness.

“Maybe it would be better if I wasn’t here”

“I’d like to sleep and never wake up”

“I’d like to go away… disappear”

“If something like that happened to me, I think I’d kill myself”

“Nobody cares”

“I’m going to end it all”

“What’s the point of living?”

“Soon, you won’t have to worry about me”

“Who cares if I’m dead anyway?”

Fascination with death: Asking others about death or what happens after death, overly involved in news about other suicides, especially recent ones.

This is not to be confused with the curiosity about their own death and funeral or preoccupation with philosophical, metaphysical, or religious questions in young adults that are otherwise happy and well adapted.

Giving gifts, contacting long lost friends or family to say goodbye, cleaning out their rooms because they don’t need those things anymore

Frequent bodily, health-related complaints

Frequent complaints of fatigue, feeling exhausted

Frequent headaches

Upset stomach

Lethargy and irritability

Problems concentrating, focusing, or remembering

Depressed and/or anxious students often describe feeling that their minds are in a fog, jammed up, or racing.

Difficulty expressing thoughts; needing more time to process and express their thoughts or describe their experience

Traumatic or unexpected events at home may increase feelings of guilt or helplessness

Severe illness (mental or physical)

Deaths

Legal problems, arrests

Financial stress

International conflict, war

Traumatic events experienced by the student or someone close to him/her

Sexual assault / rape

Car accidents

Victim of crime

Victim of prejudice or racism

Domestic violence

Acculturation stress

Failing to make adequate progress in their studies

Finding out that he/she doesn’t have the abilities for their chosen field of study or career

Breaking up of a significant romantic relationship

Conflicts with close friends

Suicide of a person they know or in their community

Being disciplined at school (feelings of shame and guilt, excessive preoccupation about what others –friends, family, faculty- are thinking of them)

Struggle with sexual orientation or gender identity

Major changes to the student’s religious meaning-making system

How to Interact with a Distressed Student

You can demonstrate your concern about the student’s wellbeing by approaching him/her directly; letting him/her know that you’ve noticed that he/she is struggling and that you are available to listen and explore alternatives. Your interest and availability convey that you care and may allow a distressed student to be more receptive to your concerns. Request to meet with the student in a place that offers privacy, where you and the student can feel safe. As you engage the student, know your limits. Involve yourself only as far as you are willing to go. At times, in an attempt to reach or help a troubled student, you may become more involved than time or skill permits. Extending oneself to others always involves some risk, but it can be a gratifying experience when kept within realistic limits. If you’re not sure whether you’re overextending yourself, seek consultation. Consider these four steps when helping a student in distress:

Reflect with empathy: Restating in your words what you heard in a calm, non-threatening, non-judgmental voice. This suggests to the student that you are actively listening to him or her. For example:

Student: "The assignment you gave is very confusing"

Faculty: "So, I gather you’re having a hard time with the assignment"

Validate: Listen carefully to the student’s story. Allow him/her time to share their concerns and try to imagine things from his/her point of view without necessarily agreeing or disagreeing; e.g., “I can see why you may be confused.”

Affirm: "I think that with some help you would be able to make sense of what the assignment is all about."

Explore the problem

Ask for specifics in a calm empathetic tone. This allows you to obtain more information about the issue in question, leading to greater possibility of problem solving; e.g., "What exactly about the assignment is making it confusing to you?"

Collaborate: Communicate with the student an intent to remain in a partnership role with the student; e.g., "Here are some ways in which I can help or you can get help."

Empower: Help the student identify ways to resolve the problem responsibly.

Encourage: Instill hope in the student; e.g., "I believe that using this strategy you have a good chance of doing well…."

Refer for further assistance

Recommend a resource on campus for further assistance.

Reassure: This helps reduce student’s level of anxiety, allowing him or her to envision some relief.

Follow Up:

Reconnect with the student within a short time frame to ask about progress. This step helps the student understand that you truly care

Reaffirm the student: This communicates to the student care, concern, and a genuine desire to see him or her succeed, and gives the student an extra empowerment boost

Consult with a Counselor

If you are unsure about how to respond to a specific student, consult with one of the professional staff at the Counseling & Testing Center. A counselor can help you explore how to approach the interaction with the student, assist you in identifying campus and community resources that might fit his/her needs, and provide coaching on how to make a referral. Counselors are available during business hours for phone or in person consultations at the CTC. You can call the front desk (269-471-3470) to schedule a phone consult or to arrange a meeting at the counselor’s office.

Make a Referral

If you feel the student would benefit from professional counseling, make a referral. Let the student know that you believe a counselor would be of help in this situation. Inform the student that counseling is both confidential and free of charge. Share the CTC website (andrews.edu/ctcenter), so the student can learn more about the services available for him/her.

A mutual decision is best. Don’t force the issue if the student takes a defensive posture; simply restate your concerns and recommendations. If the student is receptive, you can suggest that he/she call for an appointment at 269-471-3470. You may even offer to contact a counselor and provide background information. You can also offer to walk with the student to the CTC. Some students may find this comforting. After this, you can follow-up with the student by inquiring how he/she felt about the session.

If you consider the situation to be an emergency, dial 911 before contacting the CTC. Do not delay getting help for the student and making sure that you are both safe.